title: Should European perinatal indicators be revisited?
abstract: OBJECTIVE
  Our study presents the results of a survey of physicians and/or researchers working in 21 European countries, on their opinion about the relevance of perinatal indicators, in order to compare it with the EURO-PERISTAT recommendations.
  
  
  METHODS
  In this cross-sectional study, we selected 21 out of the initial set of 34 indicators of the national data supply on the European Perinatal Health Report, and added four other indicators based on expert opinion. The relative relevance of these 25 perinatal indicators was then rated by 134 respondents--expert physicians and/or researchers who have published in perinatal medicine--through a web-based survey. We summarized our data using descriptive statistics.
  
  
  RESULTS
  The top five perinatal indicators, according to the respondents' rating were: neonatal mortality rate by gestational age, birth weight and plurality; percentage of highly preterm babies delivered in units without a NICU; prevalence of severe maternal morbidity; severe neonatal morbidity among babies at high risk and prevalence of hypoxic-ischemic encephalopathy. Of these top five indicators, however, only neonatal mortality rate by gestational age, birth weight and plurality was considered a core indicator, in 2003. Moreover, severe neonatal morbidity among babies at high risk and prevalence of hypoxic-ischemic encephalopathy, that were considered in 2003 as requiring further development, were now considered by the respondents as highly relevant.
  
  
  CONCLUSIONS
  Current views of European physicians and/or researchers working in the perinatal field may not be in agreement with the EURO-PERISTAT recommendations. A revision of the set of perinatal indicators is, therefore, mandatory if a more comprehensive view of health care systems performance across Europe is to be achieved.
authors.affiliation: Department of Health Information and Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Center for Research in Health Technologies and Information Systems, Portugal. Electronic address: jvasco.santos@gmail.com.
authors.forename: João V
authors.initials: JV
authors.lastname: Santos
authors.forename: Cláudia
authors.initials: C
authors.lastname: Correia
authors.forename: Filipe
authors.initials: F
authors.lastname: Cabral
authors.forename: João
authors.initials: J
authors.lastname: Bernardes
authors.forename: Altamiro
authors.initials: A
authors.lastname: Costa-Pereira
authors.forename: Alberto
authors.initials: A
authors.lastname: Freitas
mesh_terms: D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics / Q000592:standards*; D018743:Perinatal Care / Q000592:standards*; D010500:Perinatology; D019984:Quality Indicators, Health Care
keywords: Europe; Health care; Health information systems; Perinatology; Quality indicators